title: Fractionated stereotactic radiotherapy for 136 patients with locally residual nasopharyngeal carcinoma.
abstract: BACKGROUND
  To evaluate the efficacy and toxicity of fractionated stereotactic radiotherapy (FSRT) in patients with residual nasopharyngeal carcinoma (NPC).
  
  
  METHODS
  From January 2000 to December 2009, 136 NPC patients with residual lesions after primary radiotherapy (RT) were treated by FSRT. The total dose of primary RT was 68.0-78.0 Gy (median, 70.0 Gy). The median time from the primary RT to FSRT was 24.5 days. Tumor volumes for FSRT ranged from 0.60 to 77.13 cm3 (median, 13.45 cm3). The total FSRT doses were 8.0-32.0Gy (median, 19.5 Gy) with 2.0-10.0 Gy per fraction.
  
  
  RESULTS
  Five-year local failure-free survival (LFFS), freedom from distant metastasis (FFDM), overall survival (OS), and disease free survival (DFS) rates for all patients were 92.5%, 77.0%, 76.2%, and 73.6%, respectively. No statistical significant differences were found in LFFS, DFS and OS in patients with stage I/II versus stage III/ IV diseases. Nineteen patients exhibited late toxicity. T stage at diagnosis was a significant prognostic factor for OS and DFS. Age was a prognostic factor for OS.
  
  
  CONCLUSIONS
  FSRT after external beam radiotherapy provides excellent local control for patients with residual NPC. The incidence of severe late toxicity is low and acceptable. Further investigation of optimal fractionation regimens will facilitate reduction of long-term complications.
authors.affiliation: Department of Radiation Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing 100021, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Liu
authors.forename: Jian-ping
authors.initials: JP
authors.lastname: Xiao
authors.forename: Guo-zhen
authors.initials: GZ
authors.lastname: Xu
authors.forename: Li
authors.initials: L
authors.lastname: Gao
authors.forename: Ying-jie
authors.initials: YJ
authors.lastname: Xu
authors.forename: Ye
authors.initials: Y
authors.lastname: Zhang
authors.forename: Xue-song
authors.initials: XS
authors.lastname: Jiang
authors.forename: Jun-lin
authors.initials: JL
authors.lastname: Yi
authors.forename: Jing-wei
authors.initials: JW
authors.lastname: Luo
authors.forename: Xiao-dong
authors.initials: XD
authors.lastname: Huang
authors.forename: Fu-kui
authors.initials: FK
authors.lastname: Huan
authors.forename: Hao
authors.initials: H
authors.lastname: Fang
authors.forename: Bao
authors.initials: B
authors.lastname: Wan
authors.forename: Ye-xiong
authors.initials: YX
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002277:Carcinoma; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D018365:Neoplasm, Residual; D011379:Prognosis; D016016:Proportional Hazards Models; D016634:Radiosurgery / Q000009:adverse effects / Q000379:methods*; D011878:Radiotherapy; D055815:Young Adult